Assessment of Hyperpituitarism: Video, Anatomy, Definition & Function | Osmosis

Question

A 41-year-old woman comes to her outpatient provider because of skin changes that began three-months ago. She has noticed increased bruising and the development of purple-red stretch marks on the abdomen. Past medical history is notable for asthma, for which she intermittently uses a budesonide inhaler. She smokes half-a-pack of cigarettes per day. In the office, her temperature is 37.7°C (99.9°F), pulse is 71/min, respirations are 19/min, and blood pressure is 142/85 mmHg. Physical exam confirms the presence of ecchymoses and abdominal striae. Laboratory testing reveals the following findings:

Laboratory value	Result
Sodium	146 mmol/L
Potassium	3.9 mmol/L
Bicarbonate	26 mmol/L
Fasting glucose	137 mg/dL
24-hour urine cortisol*	72 µg/day
Serum ACTH**	35 pg/mL

*Normal range: 4-40 µg/day
**Normal range: 5-20 pg/mL

The serum cortisol levels are significantly reduced in response to a high-dose of dexamethasone. Which of the following is the most likely underlying pathophysiology for this patient’s condition?

Accepted Answer

ACTH-producing pituitary adenoma

Answer

Glucocorticoid overproduction by adrenal tumor

Answer

Excess ACTH production by lung tumor

Answer

Exogenous glucocorticoid intake

Answer

Overactive posterior pituitary tumor

Questions or feedback?

Hyperpituitarism

Pathology

Endocrine system